Livelli di autonomia dei pazienti sottoposti a impianto di pacemaker cardiaco: studio pilota sugli effetti della mobilizzazione precoce

Introduction Although there are no specific indications from the literature, in many cases patients undergoing pacemaker implantation are prescribed bed rest for at least 24 hours. The aim of this pilot study was to evaluate the effects of earlymobilization (3 hours after surgery) in terms of levels of independence and rate of postoperative complications. Materials and methods The study was performed on 32 patients who underwent pacemaker implantation at the Centro Cardiologico Monzino of Milan between September and December 2010. The participants were randomly assigned to the experimental group (mobilization 3 hours after surgery, with the application of non-adhesive elastic bandages around the shoulder ipsilateral to the implant) or the control group (mobilization 36 hours after surgery); each group was composed by 16 subjects. Patients’ levels of independence were assessed on admission and 6, 12 and 36 hours after the pacemaker implantation using the Functional Independence Measure (FIM) scale®. Both direct implant-related and indirect clinical complications were recorded. Results The scores registered at 6 and 12 hours after the intervention show that for several items of the FIM scale® the levels of independence were significantly greater among patients in the early mobilization group. Overall the postoperative complication rate was higher in the early mobilization group (37.5%vs 31.3%), but the difference was not statistically significant. Conclusions Mobilization at 3 hours after pacemaker implantation, with non-adhesive elastic dressing, is associated with faster recovery of autonomy as assessed by the FIM scale®.